CASE LEARNING OBJECTIVES
Evaluate pediatric immunization records and identify missing immunizations
Recognize appropriate contraindications for holding immunizations until a subsequent visit
Develop an appropriate plan for vaccine catch-up including selection of appropriate vaccine products for pediatric immunizations
Properly educate caregivers regarding premedication, adverse effects of vaccines, and vaccine controversies, such as autism
"Lately my son has been fussy and doesn't sleep very well. His forehead was warm to touch last night and I am concerned that he may be coming down with something."
History of Present Illness
Kyle Smith is an 18-month-old male toddler who was brought into his pediatrician's office (use today's visit as 08/01/2012) by his mother. The mother notes that her son has been irritable and demonstrates difficulty sleeping over the past few days. Additionally, she reports that he has been eating less with meals over the past few days and has been tugging on his right ear for the past day or so and has become increasingly fussy. His mother has no other complaints at this time.
Normal spontaneous vaginal delivery (NSVD) at 37 weeks' gestation. No hospitalizations or complications since birth.
The patient lives at home with mother and father. He attends day care during the weekdays as both parents work full time. Siblings include a 4-year-old sister who also attends day care as well as preschool.
Allergies/Intolerances/Adverse Drug Events
Green gelatin ("itching" per mother)
Acetaminophen infant drops 130 mg PO q 6 h PRN fever, last dose given at 21:00 last night
Please see attached immunization record for this patient.
Per mother, the patient has not experienced any adverse reactions with immunizations except for some mild erythema with the Pediarix vaccine.
Positive for fever and decreased appetite; negative for rashes, bruises, recent trauma, or accidental falls; negative for discharge from the eyes or ear pulling; negative for nausea, vomiting, or changes in bowel or urinary patterns; positive for decreased oral intake; negative for lethargy
Irritable and fussy 18-month-old male in no acute distress
BP 100/55 mm Hg, P 95, RR 24, T 37°C
|Birthdate: 1/1/2011 || || || || |
|Vaccine ||Product Name ||Date Given ||Route and Site ||Vaccinator Signature/Initials |
|Hepatitis B ||Recombivax HB ||1/1/2011 ||IM ...|
Log In to View More
If your institution is currently a subscriber
of Pharmacotherapy Principles & Practice please sign in below.
If your institution is not a subscriber
please click here
to learn more.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.